Blood-Based Biomarker Testing for Dementia Enters Primary Care, but Clinician Confidence and Patient Education May Shape Uptake
KEY TAKEAWAYS
- Fewer than 1 in 5 primary care clinicians reported sometimes or routinely ordering plasma biomarker tests for suspected cognitive impairment.
- Clinicians with greater diagnostic confidence were more likely to use blood-based biomarkers, whereas lower confidence was linked to more neurology referrals.
- Patients were largely receptive to testing after brief education, but cost, reliability, and emotional support remain key concerns.
Biomarker Testing in Primary Care
Implementation of blood-based biomarker testing for Alzheimer disease (AD) in primary care has started, but adoption remains limited, according to findings from the National Dementia Workforce Study presented at the American Geriatrics Society 2026 Annual Scientific Meeting. In the nationally representative survey, 16.7% of primary care clinicians reported sometimes or routinely ordering plasma biomarker tests for suspected cognitive impairment.
Testing was less common than neuropsychological assessment (71.1%) and CT imaging (77.4%), similar to PET imaging (18.4%), and more common than CSF testing (3.7%) or DNA testing (1.4%). Among primary care clinicians, 21.7% reported low confidence diagnosing dementia in adults aged 65 years or older, and 41.2% reported low confidence diagnosing AD. Lower diagnostic confidence was associated with increased neurology referral, whereas higher confidence was associated with greater use of plasma biomarkers.
Patient Views on Biomarker Testing
Results from a separate cross-sectional study published in Alzheimer’s & Dementia suggest that many primary care patients are open to blood-based biomarker testing when the purpose and limits of testing are explained. In surveys of 572 adults from Chicago-area clinics, 83.7% were unfamiliar with AD blood-based biomarkers and 1.8% had previously completed testing. After a brief educational intervention, 94.5% supported offering tests to patients with memory or thinking concerns, and 85.0% said they would undergo testing if recommended by their primary care clinician.
Factors Influencing Uptake
Patients most often supported testing if results could guide care (94.2%), were covered by insurance (93.4%), were preceded by clear education (88.5%), and were easy to access (88.1%). The most common barriers were cost (49.3%), concern about reliability (35.3%), concern about being treated differently after a positive result (24.2%), and fear of a positive result (21.7%).
Together, the studies suggest that blood-based biomarker testing may become more common in primary care, but implementation will likely depend on clinician guidance, test access, insurance coverage, and support for patients receiving positive results.
References
- Arteaga I, Spetz J, Chiong W. Plasma biomarker testing in primary care: early findings from the National Dementia Workforce Study. Presented at: American Geriatrics Society 2026 Annual Scientific Meeting. April 30–May 2, virtual. https://meeting.americangeriatrics.org/sites/default/files/media/files/AGS26%20JAGS.pdf
- Salahi L. Confidence shapes referral and uptake of blood-based biomarkers for dementia. Medscape. Published May 7, 2026. Accessed May 21, 2026. https://www.medscape.com/viewarticle/confidence-shapes-referral-and-uptake-blood-based-biomarkers-2026a1000enz?ecd=a2a
- Russell A, Vogeley A, Lovett R, et al. Patient views on blood-based biomarker tests for Alzheimer’s disease in primary care. Alzheimers Dement. 2026;22:e71247. doi:10.1002/alz.71247. https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.71247